Health and Homelessness
This content discusses the unique health-related challenges faced by homeless individuals, highlighting opportunities to enhance healthcare and outcomes. It covers the impact of housing on health, effects of homelessness on both adults and children, the cost of homelessness, and a case study on Harbor Place.
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Health and Homelessness Challenges & Opportunities at the Intersection of Health & Homelessness
Purpose: Provide an overview of the unique health-related challenges of persons who are homeless and highlight opportunities to improve health care and health outcomes for this population.
Housing is a key component of health and health care. Access to stable housing and supportive services are critical for the recovery of people experiencing homelessness. - National Alliance to End Homelessness
2009 Nationwide Health Center Patient Survey conducted by the Health Resources and Services Administration Bureau of Primary Health Care
Effects of Homelessness on Health Homeless individuals are twice as likely to have had an Emergency Room visit within the last year than their housed counterparts. More than 1 in 3 people experiencing homelessness report multiple chronic health conditions. Average life span of a person who is chronically homeless is 15 years less than their housed counterparts. Sources: National Health Care for the Homeless Council 2009 Health Center Survey
Effects of Homelessness on Childrens Health Children who experience post-natal homelessness are 22% more likely to have been hospitalized since birth than their housed counterparts. Compared to their peers, children who are homeless are 4x more likely to develop asthma, have 5x more gastrointestinal problems and 2x more ear infections. Sources: Children s HeathWatch Seattle University s Project on Family Homelessness
$$ The Cost of Homelessness $$ In MA, healthcare expenditures of homeless individuals on Medicaid are 3.8 times the rate of an average Medicaid recipient People struggling with homelessness spend, on average, 3 nights per visit in the hospital which can cost over $9,000. Sources: Health care utilization patterns of homeless individuals in Boston: preparing for Medicaid expansion under the Affordable Care Act. Green Doors
Opportunities Case Study: Harbor Place
Opportunities Case Study: Harbor Place Champlain Housing Trust purchased the 59-room motel in 2013 The UVM Medical Center contributed $25,000 in seed capital and $15,000 to CHT to pay in advance for 550 nights for its patients over the course of the next year Other contributors include the State, United Way, Fanny Allen Foundation: $300,000 operating reserve Discount rate contracts with State, UVM Medical Center and local services agencies Onsite case management services available through local partners 1,397 unduplicated guest households in first three years
Cost Savings Statewide average motel voucher room = $73/night Average discount Harbor Place cost = $38/night
Harbor Place Patient Intervention Study What is the impact of discharge to Harbor Place on health care cost and utilization?
Harbor Place Patient Intervention Study Cost per Visit Before/After Stay $7,000 $6,013 $5,973 $6,000 $5,000 $4,757 $4,000 $3,000 $2,699 $2,246 $1,943 $2,000 $1,000 $0 91 - 120 Days Prior 61 - 90 Days Prior 00 - 60 Days Prior 00 - 60 Days After 61- 90 Days After 91 - 120 Days After Before Motel Stay After Motel Stay Series1
Harbor Place Patient Intervention Study Direct Costs Before/After Stay $1,800,000 $1,570,993 $1,600,000 $1,400,000 $1,200,000 $1,000,000 $800,000 $600,000 $400,000 $252,110 $222,359 $168,374 $200,000 $80,960 $58,276 $0 91 - 120 Days Prior 61 - 90 Days Prior 00 - 60 Days Prior 00 - 60 Days After 61- 90 Days After 91 - 120 Days After Before Motel Stay After Motel Stay Direct Costs $
Opportunities Case Study: Rutland County Housing Specialist from the Homeless Prevention Center provides services to patients in the Emergency Department who are experiencing housing issues Rutland Regional Medical Center as a key supporter of the creation of a family homeless shelter Community Health Team participation in the Rutland County Continuum of Care
Opportunities Case Study: Better Health Through Housing Initial investment: $250,000
Opportunities Case Study: Better Health Through Housing After one year, average monthly cost for patients in the program decreased by 42 percent Cost per month to pay for individual s apartment: $1,000 vs. Cost per day to hospitalize that same patient: $3,000
"A stable environment is the first step toward establishing long-term health. Better Health Through Housing is taking proven steps to positively impact the health and lives of Chicago's most vulnerable individuals. Dr. Avijit Ghosh, CEO of the UI Health Hospital & Clinics
Sources https://www.nhchc.org/wp-content/uploads/2011/09/Hln_health_factsheet_Jan10.pdf https://www.ncbi.nlm.nih.gov/pubmed/23134588 http://hospital.uillinois.edu/Documents/Service%20Lines/BetterHealthThroughHousing/housingFirst_Final2.jpg http://www.endhomelessness.org/pages/cost_of_homelessness Children s HealthWatch Sheward Presentation Improving Health Through Housing: Collaborative Approaches to Combat Homelessness, by Margaret Bozik, Erin Ahearn & Jason Williams Health care utilization patterns of homeless individuals in Boston: preparing for Medicaid expansion under the Affordable Care Act. http://www.greendoors.org/facts/cost.php http://www.npr.org/sections/health-shots/2016/06/29/482994000/a-hospital-offers-frequent-er-patients-an-out-free- housing http://hospital.uillinois.edu/about-ui-health/community-commitment/better-health-through-housing
